Vitamin Information Center

Increased intake of calcium and vitamin D can help prevent or slow bone loss in men, according to a pair of studies conducted by researchers from Deakin University in Melbourne, Australia.

An estimated 75 million women and men in the United States, Europe and Japan suffer from osteoporosis, a disease in which bones become thin and brittle.

Prior research has demonstrated that both calcium and vitamin D are important for the bone health of women, who are four times more likely to develop osteoporosis than men. In a 2006 study published in the journal Bone, scientists also found that older men who drank fortified milk daily experienced a 1.8 percent increase in the bone mineral density of their hip bones and a 1.5 percent increase in the density of their wrist bones.

The fortified milk contained 500 milligrams of calcium and 400 IU of vitamin D3, as well as other vitamins and minerals. The researchers noted that because the participants were given fortified milk instead of individual vitamin supplements, it was not possible to determine whether the bone density increase came from the calcium, the vitamin D, both, or some combination of those nutrients with others found in the milk.

The researchers also noted that while calcium intake was higher in participants who drank fortified milk than in control participants, this difference was not statistically significant.

In a more recent study, published in the American Journal of Clinical Nutrition, researchers followed up with 109 of the original study participants 18 months after that study’s conclusion. During that time, the participants had not been provided with fortified milk, but the bone-density improvements from the first study were still apparent.

The researchers suggested that supplementation of milk with calcium and vitamin D3, as is done in Canada, could lead to long-term bone health benefits for older men.

It takes more than drinking milk to strengthen our bones. Milk is certainly a good source of calcium, but it is only one option to prevent or retard osteoporosis, the disease that affects one out of every two women over the age of 50.

Bone density begins its slow decline between the ages of 25 and 30. By the age of 70, women can lose up to 30 percent of that density. By age 75, osteoporosis becomes as common in men as it is in women.

Osteoporosis means “porous bones” and is considered the third-leading health issue in our country, after cardiovascular and cancer problems. The most threatening areas for fractures to occur are in the spine, hips and wrists.

When bones become weak and brittle, actions as easy as bending over or even coughing can cause fractures. While hip fractures usually are a result of a fall, many fractures occur without involving any falls.

Compression fractures can develop when bones in your back simply become too weak, resulting in a stooped posture. This will increase pressure around your spine, eventually causing more compression fractures.

Three of the major risk factors for osteoporosis that we can control are lack of regular exercise, too little calcium intake and an inadequate amount of vitamin D, which is essential for calcium absorption.

People who have been physically active in their younger years have an advantage over their non-active friends: While the active types may lose some bone as they age, their chances of suffering fractures from having brittle bones are greatly reduced.

It never is too early or too late to begin strengthening the muscles and the bones. Exercise can improve muscle strength, bone density, posture and balance, all of which will help prevent falls.

If you already have osteoporosis, exercising can help maintain your bone mass. You should replace any high-impact exercise that could place stress on your spine (such as jogging) with more gentle weight-bearing exercises (walking).

Similarly, bending and twisting movements at the waist (such as in golf, tennis and situps) should be avoided, because they could cause the already weakened spinal bones to compress and possibly fracture.

It is important to check with your physician or physical therapist before you begin exercising, because you need to find the safest and most enjoyable exercises depending on your degree of bone loss.

Exercise prevents osteoporosis

Muscles become stronger and bone density increases as you place demands upon them; bone is a living tissue that reacts positively to exercise.

Commitment to consistent exercise is essential, because once you cease exercising, bone density benefits will also cease.

For strengthening and helping to maintain healthy bones, it is recommended to do weight-bearing exercises a minimum of 30 minutes for three days per week and resistance exercises two or three times a week.

What type of exercise is best

Weight-bearing exercises require your body to work against gravity: jogging, brisk walking, stair climbing, racquet sports and dancing are good examples. Swimming and biking, while excellent for cardio workouts, are not considered a weight-bearing exercise.

However, in some stages of osteoporosis, water exercises may be used in rehabilitation. Resistance exercise (strength training) strengthens muscles and bones throughout the entire body. These exercises involve using your muscular strength to work against the weight of another object, such as using free weights, weight machines or resistance bands.

For some resistance exercises, you can even use your own body weight as the exercise load. Balance, coordination and flexibility exercises for fall prevention include standing on one leg, sitting and exercising on an exercise ball, tandem walking, stretching, dancing, tai chi and yoga.

Nutritionally speaking

According to the National Institutes of Health, people with vitamin D deficiencies absorb less than 10 percent of available calcium they ingest. Three of the leading contenders for calcium are plain low-fat yogurt, fruit yogurt and whole, low-fat or fat-free milk.

Our body’s absorb vitamin D through sunlight and vitamin D-fortified foods, such as milk. Here are a few added suggestions to fortify your 206 bones:

• Treat yourself to 15 minutes a day without any sunscreen. That is what your body needs to produce vitamin D, the “sunshine vitamin.”

• Almonds are packed with bone health. A handful counts for about 70mg of calcium.

• Studies indicate that a cup of tea a day increases bone density.

• Eat brown instead of white. Brown rice has three times the calcium than white rice.

• Try having chopped figs over yogurt for a snack; it will give you almost half the needed calcium requirements for the day.

If you are 50 or older and have not been exercising, check with your physician before beginning ANY exercise program. Sally Anderson, a trainer, is happy to hear from readers but cannot respond to individual queries. Write her in care of LifeTimes, St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731.

Hip extensions

Strengthens hips and thighs. Place one hand on a countertop. Keeping hips facing forward, slowly lift one leg out to the side, knee facing forward, as Royce demonstrates at left. Hold a few seconds, then slowly return leg to ankle, never touching the floor. Repeat 8 to 10 times. Priscilla shows the next movement: Lift leg diagonally to the back. Hold, then slowly release leg; repeat 8 to 10 times. Tips: Contract abdominals and do not lock knees. You may add ankle weights later.

Tandem walk

Develops balance. (Not shown.) Stand with fingers lightly supported on a counter or a wall. Looking straight ahead, walk, placing one foot directly in front of other foot, making sure front heel is close to back toes; aim for 15 to 20 steps. Then, if you do not have foot or ankle issues, try walking on your heels, with the balls of your feet lifted up. Tip: Walk tall, do not lean forward.

Wringing the towel

Strengthens the wrist. Hold a towel in both hands, keeping elbows close to your sides. Wring the towel out as hard as you can, extending one wrist and flexing the other wrist at the same time; do 10 to 15 repetitions. Tip: Use your wrist muscles, not your fingers.

Back extension

Strengthens shoulders, back, neck, spine and hips. Begin by lying on your stomach on a mat with arms in front of you, palms facing downward. Keeping legs on mat, lift head, arms and chest off the mat. Bend elbows, bringing them in toward your shoulders, feeling a slight pinch of the shoulder blades. Hold for several seconds, then extend arms to original position and repeat several times. Tip: Do not hold your breath.

Wringing the towel

Strengthens the wrist. Hold a towel in both hands, keeping elbows close to your sides. Wring the towel out as hard as you can, extending one wrist and flexing the other wrist at the same time; do 10-15 repetitions. Tip: Use your wrist muscles, not your fingers.

The benefits of a combined vitamin D3 and calcium for bones, reported to stop or slow bone loss, may extend for up to 18 months after stopping supplementation, suggests a new study from Australia.

The increases in bone mineral density of about 1.65 per cent observed in men after receiving vitamin D and calcium supplements were still evident 18 months after the men stopped taking the supplements, researchers report in this month’s American Journal of Clinical Nutrition.

The study shows that elderly men, a population that is often overlooked in bone health studies, could also benefit from daily supplements of fortified milk.

Much focus has been on the vitamin D and calcium combination for bone health in women since elderly females are four times as likely to develop osteoporosis than their male counterparts. The new study, which follows on from an earlier study in the journal Bone (doi: 10.1016/j.bone.2006.04.003), reports that elderly men benefited from daily supplements of fortified milk.

Osteoporosis is estimated to affect about 75m people in Europe, the USA and Japan. According to the International Osteoporosis Foundation, the total direct cost of osteoporotic fractures is €31.7bn in Europe, and 17.5bn in the US (2002 figure).

Robin Daly and co-workers from Deakin University in Melbourne followed 109 who had completed the earlier study for a further 18 months, during which no more fortified milk was provided.

The benefits on bone mineral density observed in the on the hip bone (femoral neck) and wrist (ultra-distal radius) at the end of the intervention of 1.8 and 1.5 per cent, respectively, were still evident 18 months later.

Furthermore, non-significant increases at the total hip of 0.8 per cent were also sustained.

“The average total dietary calcium intake in the milk supplementation group at follow-up approximated recommended amounts for Australian men older than 50 (1000 mg/d) but did not differ significantly from that in the control subjects (1021 versus 890 mg/d),” stated the researchers for clarification.

“Supplementation with calcium- and vitamin D3-fortified milk for two years may provide some sustained benefits for BMD in older men after withdrawal of supplementation,” they concluded.

The researchers reported in the earlier study in Bone that, due to the complicated nutritional mixture of the milk, it was not known whether the benefits were due to vitamin D3, calcium, or a combination of these plus other nutrients. They did state however that the results show a reduction in bone resorption in this elderly male population sample.

The fortified milk used in the initial intervention contained 500 milligrams of calcium (milk calcium salt NatraCal) and 400 International Units (IU) of vitamin D3 (DSM Nutritional Products), and was formulated by Murray Goulburn Co-operative in Brinswick, Australia.

Some countries, like Canada, already fortify their milk and a 250 ml cup provides about 90 IU of vitamin D. In the UK, where milk is not fortified, a 250 ml cup contains only a trace of the vitamin.

The 1999 USDA survey on food intakes by individuals reported that less than 15 per cent of over-sixty year-old men were meeting their recommended daily intake of calcium.

Source: American Journal of Clinical Nutrition
March 2008, Volume 87, Number 3, Pages 771-777
“The skeletal benefits of calcium- and vitamin D3-fortified milk are sustained in older men after withdrawal of supplementation: an 18-mo follow-up study”
Authors: R.M. Daly, N. Petrass, S. Bass, C.A Nowson

Calcium supplements are usually only required where dietary calcium intake is deficient. This dietary requirement varies with age and is relatively greater in childhood, pregnancy and lactation due to an increased demand, and in old age, due to impaired absorption. Continue Reading…